Never Tell Our Business to Strangers

by Jennifer Mascia

  A few minutes later she was stabilized. Dr. M. emerged and informed us that her blood pressure was jumping all over the place and things didn’t look good.

  “I would say her prognosis is very poor,” he said. The words hit my spine like electric spikes. “We think she might have pneumonia.”

  “Pneumonia?” Arline said. Pneumonia was never good.

  “Well, I’m not entirely sure it’s pneumonia, actually,” Dr. M. clarified. “Something is causing her white blood cell count to spike, I’m just not sure what it is. It’s an infection of some kind, maybe sepsis.” I called Dr. G., my mother’s cardiologist, who relayed that Dr. M. had called earlier and told him that my mother hadn’t released urine in twenty-four hours, an indication that her kidneys were shutting down.

  “I love how you’re the one to tell me this,” I said, “and not her actual doctor.”

  “The only thing that will help her produce urine is dialysis,” Dr. G. explained, “which would serve as a stop-gap that will hopefully jump-start her kidneys into action. Once she’s able to produce urine again we can resume treatment for the heart attack. We just want to get her stable again so we can transfer her here.”

  “You know what I want more than anything?” I said in a rare moment of whimsy. “I want to be able to tell her everything we went through this week and I want her to laugh and say, ‘Aw, honey, it’s all right now, I’m fine.’ Maybe not perfect, because she’s still going to have cancer, but alive. That is what I want.”

  “I would like that very much,” he said. “I would love to meet your mom and talk about all this with her, and tell her what a wonderful and caring daughter she has. That’s our goal, and we need to keep sight of that goal. Okay?”

  “Yes,” I said. “But I need you to level with me. How bad is this, really? Because I keep hearing ‘poor prognosis.’ You’re not here, but you do have some perspective. And even though five doctors seem to have sprouted up around my mother’s bed overnight, you’re the only one who is really on the case. I need to know what you think.”

  He sighed. “Honestly? We need to get her kidneys working again. This is a turning point. If her kidneys shut down completely, all of her organs will eventually follow suit. If we can get them restarted, I think she has a good chance.”

  So this was it. I really was suspended in the present, prey to a wind that could knock me to the ground if it chose. I left the hospital soon after to collect my sister Tina from JFK airport. I can’t remember when I’d called her; it must have been sometime the day before. Or maybe it was Saturday?

  “Tina,” I’d started.

  “Well, hello, Miss Jennifer,” she said in her Florida twang. “What’s goin’ on?”

  “Oh, not much,” I said. “Tina, my mom had another heart attack.”

  “Oh, no,” she said in hushed tones. I remembered giving her and Angie a play-by-play of the last hours of my father’s life via telephone, an arrangement that seemed to be repeating itself now. But this time Tina said she was flying up. A couple of phone calls later she reported that Angie would be a few flights ahead of her.

  “Really?” I asked. “You’re coming up here?”

  “Of course, Jenny,” she said. I was pleasantly surprised that my half-sisters, who hadn’t flown up to watch my father die, would travel here with very little notice to be with their stepmother as she fought for her life. Maybe they were closer to Eleanor than I thought. Maybe her nagging phone calls about her ungrateful daughter and my father’s awful family and insensitive oncologists had ingratiated her in ways I didn’t appreciate.

  It didn’t hit me until later, as I roamed the JetBlue baggage carousel that afternoon, scoffing at the dingy floor and the paint peeling off the walls: They were coming for me. They were coming up because, after my parents, they were the closest family I had. I looked around. This was it for me—they were all I had left.

  “Tina,” I said, collapsing into her arms as soon as I saw her. She looked so much like my father it startled me, especially since she was allowing her prematurely gray hair to overtake the auburn. I wondered if he’d be happy knowing his girls would all be together, then realized I already knew the answer.

  Wednesday, January 11, 11:30 A.M.

  When I signed off on my mother’s dialysis I didn’t really know what it would entail. I knew end-stage diabetics require the procedure several times a week and it’s a major hindrance, but I visualized an IV that takes blood out and another that puts it back in, with some kind of a filter in between. So nothing prepared me for the horror I found when I opened the sliding glass door that morning.

  My eye was immediately drawn to the tubes, dozens of them now, flowing from bags and machines into every possible orifice save her ears. But the dialyzer was appalling: It looked like a giant stand-alone reel-to-reel tape player. I watched aghast as her blood was pumped through a plastic tube into the reel-to-reel, looped around, separated from the urine, and sent back into her body through another plastic tube. All this while the ventilator made a soft whooshing sound to remind me that it was breathing for her, just in case I’d forgotten. For such a busy room with so many vital processes occurring at once, it was relatively quiet, which made the atmosphere rather eerie. I moved a few inches toward her and noticed that her face had grown puffy from the accumulation of fluids, but her eyes, thankfully, were tightly closed. Though the monitors’ discordant minor notes dutifully registered her heartbeats, I knew that she was gone.

  “It’s not her,” I said to Arline and Tina. “She’s not here anymore.”

  “No,” Arline immediately agreed with me. “She’s not.” She moved to my mother’s side, took her hand, and began weeping gently. Tina flipped through my mother’s chart and shook her head. “Jenny, her lab values are really poor,” she said. “Her levels are not good at all.” She drew aside the blanket warming my mother’s feet and said, “Oh, no, Jenny, look.” I walked over and she pointed out the red dots that had broken out all over her hands, arms, and legs. “Her capillaries are breaking down,” she said. “They’re no longer carrying oxygen to her skin.” She ran her finger along my mother’s right leg. “Her extremities are cold.” Tears sprang to her eyes. “Oh, Miss Eleanor,” she said, her nose flushing red.

  I sat in a chair across the room. I wanted to be as far from my mother as possible without ending up in the hall. I didn’t want to appear cold, but I was anxious and numb and devoid of hope. I knew the rest of her hospital stay would consist of nothing more than waiting for her to die, and I couldn’t handle the agony of not knowing when. If I was going to have to spend the rest of my life without her, I wanted the rest of my life to begin as soon as possible.

  From my seat in the back of the room I overheard Dr. M. discuss dilating the breathing tube with his staff. Within minutes he walked in and asked for my consent to open the tube to the maximum capacity. As I signed the form, I remembered less than twenty-four hours before when we all thought the breathing tube would be temporary. Now it couldn’t even get her enough air.

  “I want a DNR,” I said to Dr. M.

  “You want the DNR?” he asked, probably leery of entrusting me with anything I might later fight to overturn.

  “Yes,” I replied. “Now.” I wasn’t going to spend the next six months studying fluttering eyelids for signs of life, a perpetual captive to false hope. He produced the form and I signed it. Later that day Dr. M. told me that he thought her liver might be shutting down, and I knew it was over. My only decision now was how long I wanted this grisly scene to play out.

  AS UNNECESSARY AS I considered it to be at that point, we needed to eat. I took Tina and Arline to a gaudy diner where all the Italians convened for two A.M. Sambuca.

  “Rita’s coming tomorrow,” I informed Tina. Rita and my mother hadn’t gotten along for the past couple of years because of Rita’s drug problems, and I specifically remember my mother telling me after her cancer diagnosis that if anything happened to her there would be no need to call her youngest
sister. But that was how they all spoke about each other, depending on the day. My mother had ranted about me so much over the years that I’m sure both of my aunts thought I was the Bad Seed. But Rita wanted to be there. She was, after all, my godmother, and isn’t this the very reason why she’d stood over me in 1978 as the priest poured water on my forehead? Christ, if my mother thought for a second that Rita would be assuming parental responsibilities—even though at twenty-eight I was too old to need parenting—she’d yank out the breathing tube herself and walk home from the hospital.

  “And how is Rita?” Tina asked. Arline and I looked at each other.

  “Good,” Arline said.

  “She’s fine, I guess,” I said. The truth was that Rita’s drug of choice—currently Percocet—left her rambling only slightly coherently about subjects that ran the gamut from Rita to Rita. Occasionally she’d gripe about her daughter and marvel at celebrity breakups. Addicts are notoriously self-absorbed and feel the need to discuss themselves with anyone who will listen. It’s exhausting, and after a while my mother’s patience had simply run out.

  “Tina, I should tell you something,” I said. “It’s about Dad.” I hadn’t expected to do this—if my mother hadn’t been dying I don’t know when I would have—but since Tina was sitting in front of me I decided this was the time. “Mom told me something after she had that mini-stroke a few weeks ago. She told me more about Dad.” I dipped a fry in Russian dressing and stuck it in my mouth, but only because I was nervous. “She said that after he came out of jail in 1975 he didn’t really stop being a criminal.”

  “Oh, I know,” Tina said. “I remember when he came down to Florida with your mom, he had wiseguys over all the time. Bill and I would listen to their stories and we were, like, mesmerized.”

  I nodded, knowing full well that the bomb I was about to drop would dispel the gossipy atmosphere for good. I drew a breath and blurted:

  “Mom told me he killed four or five people during that time and never got caught.” I let it hang there for a moment.

  “Are you serious?” Tina asked, incredulous.

  “Your mother said what?” Arline said.

  I turned to Arline in shock. “You didn’t know?” I asked her. “You?”

  “She never told me,” Arline said. I hadn’t expected this. I thought for sure my mother had told her sisters. She’d talked to Arline five times a day in recent years. Maybe she told Rita, to whom she was closer at the time. I’d have to ask her. Jesus, what if I was the only person my mother told? No wonder she felt so compelled to unload as the end of her life was looming.

  “Wow,” Tina said. I thought I could see tears in her eyes.

  “Yeah,” I said. “She said they were all drug dealers, though, people who stole money from him, shit like that, and from what I gathered it stopped the second we left Florida. But one of the people he killed was sacrificed for Big Vinny.” That didn’t sound right. “You remember Big Vinny, don’t you, Tina?” I relayed the tale of Vincenzo “Big Vinny” Cassese and his dead partner, courtesy of our father. “Can you believe it?” I asked no one in particular. “He was a killer. And I lived with him and I didn’t know it.”

  “So did we,” Tina said. “So did my mom.”

  “But my mom stayed with him,” I pointed out. “Your mom got out and got herself a career. She didn’t stay married to a murderer.” She nodded. Two months later I’d visit Tina, and over seared tuna Caesar salads in Fort Pierce she’d ask me to tell her this story again, the story of Dad’s killing streak. She’d sit across from me and patiently listen, and when I finished she’d remark, “He must have been so scared,” and her brow would crumple and her eyes would turn pink and a tear would roll down her cheek. And it would take me a few minutes to figure out what she meant: that as our father faced the end of his life, he feared he’d end up in hell for what he had done.

  THOUGH RITA WANTED me to wait until she got there to take my mother off life support, no one expected me to acquiesce. My mind was made up the second I saw her blood going through the dialyzer, and nothing would give me more satisfaction than screaming, “Get every fucking tube out of my mother’s body!” right in Dr. M.’s face. I was also afraid that she’d die without me there—I feared that even more than I feared her death. The decision was mine, and Arline’s, and we both agreed: She wouldn’t want to hang around in this state. We’d look at each other every so often and say, “She’s not there anymore. It’s not her.” Whatever had been done or not done during the course of her treatment was a matter for lawyers, if we so chose. Regret and bitterness could keep me visiting her dying, mechanized body in this goddamn hospital for months on end. I knew what she wanted, and as soon as I decided to carry it out I marched through the dimming parking lot, past the turkeys, up the elevator, and into the waiting room of the cardiac intensive care unit. I had with me Arline, Tina, and a college friend, Ji Young—who arrived as soon as her classes were dismissed; she ran an after-school program in East New York—and my father’s favorite aunt, Emma, who’d taken a car service from Brooklyn.

  “I remember how ya motha and fatha drove Uncle Joey back and forth to chemo,” Emma said in the waiting room, her face pinched with her signature brand of bittersweet grief, “and how ya motha called me all the time after my heart surgery to see how I was doin’. I’ll never forget whatcha motha did.”

  My friend Sarah arrived soon after with her father, Jack. They’d left her grandfather’s posthumous birthday dinner, the first milestone since he’d died in October. She said that as soon as she got the call, she and her father hopped in his car and sped to Staten Island.

  “Jennifer,” Jack called to me. “Come over here for a second.” I followed him to a corner of the waiting room. “I just went through this, you know, with my own father. He was much older, and I’m older than you are, but if you ever need to talk, you can always call me.”

  “Thanks, Jack,” I said, knowing I would never call him—or anyone—about this, but supremely grateful that he’d left his own father’s birthday party to bring Sarah to me.

  “You know,” he continued, “when I went through this, I realized that there are two kinds of people in life: practice players and game players.” He paused a moment for emphasis. “Some people in your life will show up to every practice but skip the game; others will show up to the game even though they’ve been skipping practice, and those are the people you least expect. People are funny like that.”

  “Thanks, Jack,” I said. “I’ll remember that.” I’d learned this lesson when my father died. Some of the people closest to me couldn’t handle it and faded into the background, and their absence came as a shock, while others—always the ones I never expected—entered my life out of the blue to help shoulder the burden. I didn’t have time to wonder who would fall into which category, but I was sure I’d find out soon enough.

  I turned to my group. “Well, this is it,” I said. It was 8:00 P.M. I wondered what my mother’s time of death would be. Her gravestone, if she hadn’t requested to be cremated, would have read 10/12/1934-1/11/2006. A life lived, with all the important stuff obscured by a dash. I marched through the double doors and into the nurses’ station. Dr. S. was there, as was a slightly nervous young resident named Dr. O. “My mother is Eleanor Mascia,” I declared, “and I want to withdraw care.” They both looked at me like I was an oncoming truck.

  “Um,” Dr. O. said, looking around for backup, “we need to consult with each department first. Can you wait in the waiting room, please?” She looked about my age. Her hair was long and wavy, like mine, and she wore it loose. In every restaurant I worked I’d had to tie it back, but here she was dealing with life and death, and hers was permitted to hang free.

  “Okay, I’ll be in the waiting room,” I said. I spun around and marched back out, despite the fact that the nurses’ station faced my mother’s room. Perhaps another daughter would have gone in there and spent every last second she could with her mother, but I couldn’t stand to see h
er that way. I felt deeply ashamed about it, too, because I knew that if the tables were turned, if I had been mangled in a car accident and rendered brain-dead, for instance, she would have been right there, wiping the blood off my broken flesh with a washcloth, ignoring the fact that I couldn’t hear the lullabies she’d be singing into my ear. My mother would be strong enough to confront the death of her one and only reason for living, so why couldn’t I even summon the courage to approach her room when she was at her most vulnerable?

  There was something else: I felt I had betrayed her. Not for taking her off life support, but for putting her on it in the first place. “What were you supposed to do?” Arline asked me a dozen times that week. “You did what you had to do at the time, with that particular set of circumstances. What, were you going to just let her die without giving her a chance? You gave her a chance, Jenny.” Every friend to whom I’d expressed my doubts on that day and every day afterward said the same thing. “But she doesn’t know that,” I’d say to them. “She was promised a breathing tube so she could have an angioplasty. I tricked her. I told her it was temporary. She didn’t know she was going to die.”

  But maybe it was better this way. Maybe it was better she died without realizing it. Not from a long, protracted battle with cancer that robbed her of her hair and every ounce of her body fat, but in a twilight sleep that slowly dimmed until it was extinguished. There would be no goodbye for my mother and me, except perhaps in my dreams. But I preferred it to the alternative: an excruciating scene with the two of us sobbing, struggling with the cruelty of our separation. No, we never would have been able to say goodbye to each other. It just wasn’t possible. It took me until now to realize that “goodbye” was not something I could have ever said to the two people who had been closest to me. “Goodbye” was inadequate, “goodbye” was unimaginable; “goodbye” was simply not intended for the three of us.